Hospital to get permanent oversight

Wednesday

Feb 13, 2013 at 12:01 AM

STOCKTON - The San Joaquin County Board of Supervisors voted Tuesday to create a new governing board to oversee San Joaquin General Hospital, a move county officials said would help keep the public hospital financially sound in the rapidly shifting and ever-competitive world of health care.

Zachary K. Johnson

STOCKTON - The San Joaquin County Board of Supervisors voted Tuesday to create a new governing board to oversee San Joaquin General Hospital, a move county officials said would help keep the public hospital financially sound in the rapidly shifting and ever-competitive world of health care.

"We have to build a better mousetrap," Supervisor Larry Ruhstaller said. "We just have to be smarter, quicker, and we have to be able to react to the changes that are going to be coming at us."

The board voted unanimously to direct staff to draw up an ordinance that would create a permanent board of trustees to oversee the hospital. It would replace the current interim board of trustees, which had approved the plan to replace itself last month with a permanent board with more responsibility.

The permanent board would be the latest - though possibly not the last - change in governance at the public hospital that county officials have made in recent years to try to steady the hospital after consecutive years posting losses sometimes exceeding $20 million annually.

Changes included breaking off the hospital into its own county department and creating the interim board in 2010.

One of the temporary board's mandates is to design its permanent replacement. A subcommittee looked at examples of other changes and explored everything from keeping things the same to creating a new hospital authority to merging with an existing organization, according to a report from the committee.

One of the challenges the committee wrestled with was how to become more nimble without giving up the financial support available to public hospitals like San Joaquin General, said David Culberson, the hospital's chief executive officer.

It would be an 11-member board, including a member of the Board of Supervisors, the hospital's CEO, its chief medical officer and eight "community members." Qualifications for these members would be spelled out in as-yet-unwritten bylaws, which could include requiring a board with expertise in business management, law, finance, medical or other health professions. Board members would serve a maximum of four three-year terms.

The staff report points to a desire to more quickly recruit and hire to fill positions as one way the new board could speed up the decision-making process.

» Participate in recruiting, hiring and firing of the hospital's chief executive officer, which could include interviewing candidates and forwarding recommendations to the Board of Supervisors

» Review and guide in development of short- and long-term capital plans and budgets that would be submitted to supervisors

» Review and oversee hospital's plans to meet obligations to provide care for the county's poor

» Provide monthly and other reports to the Board of Supervisors and the County Administrator's Office

Before Tuesday's vote, the board discussion touched on the history of changes at the hospital and concerns about the unknown future as it adapts to nationwide health care reform.

Supervisor Bob Elliott asked if adding another layer would bring more efficiencies. "Are we really making ourselves more nimble, or are we adding more bureaucracy?"

In essence, the new board will be an advisory board made up of highly qualified individuals familiar with hospital operations, delivering the kind of information the Board of Supervisors needs to make sometimes difficult decisions, Supervisor Steve Bestolarides said.

But San Joaquin General's role as the county's hospital limits the available improvements to efficiency, he said.

"We can't replicate the private-sector model," he said. "We have a very uncompetitive model that we're trying to streamline."